APPENDICES FORMS Word Documents EI 5031 ATD Request EI ...

THOMAS R. SUOZZI
COUNTY EXECUTIVE
Nassau County
DEPARTMENT OF HEALTH
Early Intervention Program
Preschool Special Education Program
Physically Handicapped Children’s Program
60 Charles Lindbergh Blvd., Suite 100
Uniondale, NY 11553-3683
ABBY J. GREENBERG, M.D.
ACTING COMMISSIONER
BOARD OF HEALTH
Norma J. Henriksen Chair
Diana Coleman Vice-Chair
Ellen J. Braunstein, M.D.
Konna Kass
SERVICE COORDINATION GUIDELINES FOR PROVIDING APPLIED BEHAVIORAL
ANALYSIS (ABA) FOR CHILDREN DIAGNOSED WITH PDD OR AUTISM
1. Child must have a documented diagnosis by a qualified professional before intensive services can be
authorized. Based on the practice acts of N.Y.S., licensed psychologists and physicians are the only
individuals qualified to diagnose PDD/Autism. An original written report completed by the qualified
professional must be forwarded to Quality Assurance for review & data entry of diagnosis.
2. Once diagnosis is confirmed, parent should be given the N.Y.S. Clinical Practice Guidelines. This
should be done prior to the IFSP meeting.
3. Only children with a PDD/Autism diagnosis may receive ABA more than once per day & have monthly
team meetings with all therapists involved.
4. See your supervisor before discussing any ABA plan with parent/caregiver or provider.
It is also important to discuss ongoing service coordination with your supervisor.
5. The Team Leader will be identified and authorized for an extended visit for the monthly team meetings.
All other therapists who attend the monthly meetings are authorized for a basic visit (under their
discipline). The Team Leader may be authorized for an extended visit each week under family training.
6. Prior to a meeting, all progress reports & review requests must be reviewed with a Supervisor.
Supervisors are expected to attend meetings on all ABA cases.
7. At the IFSP parents/caregivers must be given a copy of Nassau County Department of Health Guideline
for Intensive Behavior Services. Parental signature with date is required (Form EI5191) and is to be
attached to IFSP. All services must be included in the IFSP on the outcome page under strategies.
8. Once provision of services have been arranged, the child’s weekly schedule must be provided by the
Lead ABA teacher to the Coordinator prior to authorization of services. Data entry will be done by
Quality Assurance once schedule is submitted. Any change will necessitate a new service plan
schedule to be submitted.
Φ Φ Φ Φ Φ
EI 5192 02/07
(Based on N.Y.S. Autism, P.D.D. Clinical Practice Guidelines.)